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WO2020161734A1 - Tunnel marker device for small incision cataract surgery - Google Patents

Tunnel marker device for small incision cataract surgery Download PDF

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Publication number
WO2020161734A1
WO2020161734A1 PCT/IN2020/050101 IN2020050101W WO2020161734A1 WO 2020161734 A1 WO2020161734 A1 WO 2020161734A1 IN 2020050101 W IN2020050101 W IN 2020050101W WO 2020161734 A1 WO2020161734 A1 WO 2020161734A1
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WO
WIPO (PCT)
Prior art keywords
tunnel
marker device
incision
handle
tunnel marker
Prior art date
Application number
PCT/IN2020/050101
Other languages
French (fr)
Inventor
Natwarsingh Pradeepsingh PARIHAR
Original Assignee
Natwarsingh Pradeepsingh PARIHAR
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Natwarsingh Pradeepsingh PARIHAR filed Critical Natwarsingh Pradeepsingh PARIHAR
Publication of WO2020161734A1 publication Critical patent/WO2020161734A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • A61F9/00736Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments
    • A61F9/00754Instruments for removal of intra-ocular material or intra-ocular injection, e.g. cataract instruments for cutting or perforating the anterior lens capsule, e.g. capsulotomes

Definitions

  • the present invention relates to a medical device, and more particularly, to a tunnel marker device for use in small incision cataract surgeryto make an incision of a predetermined length and width.
  • the size of the incision during the cataract surgery decides early visual rehabilitation, better unaided visual acuity and surgical safety.
  • the incision size depends on mode of nucleus delivery and type of intraocular lens used. Generally, the size of incision is about 5.5 mm to 7.0 mm in manual small incision cataract surgery.
  • the SICS construction of a small, self-sealing sclera- corneal tunnel for delivering the cataractous lens is the main objective, and the procedure of cataracts surgery can be done with either by temporal or superior incision, whichever is more convenient.
  • the SICS process comprises giving local anesthesia, creating a sclera-corneal tunnel , creating paracentesis, making the internal corneal incision, delivering Capsulorhexis and nucleus to the site, doing residual cortex aspiration and implantation of a posterior chamber intraocular lens and finally, sealing the paracentesis port.
  • Various instruments that are required for construction of the sclera-corneal tunnel are Westcott scissors, cautery, bard-parker knife with #15 blade, Castroviejo calipers, and a crescent blade.
  • Whi le creating tunnel for SICS size i .e., the length of the tunnel, shape (style) , location, depth, width and entry place into the anterior chamber are important aspects.
  • the incision for SICS is smaller for a soft cataract and larger for a dense, and hard cataract.
  • the incision is 6 to 7 mm long for a cortical cataract and 7 to 8 mm long for a hard cataract (such as 4+ nuclear sclerosis).
  • the depth should be approximately 0.3 mm to 0.5 mm.
  • the tunnel for SICS is made by advancing the crescent knife into the sclera and slowly cutting on either side, thereby making room for the crescent knife.
  • the crescent should be just visible through the sclera.
  • the heel of the crescent knife is required to be flat on the globe during dissection, ensuring uniform depth of the tunnel.
  • the sharp tunnel instruments are used to construct the tunnel.
  • the instrument like Bard-Parker knife with #15 blade , crescent knife and keratome are routiently used for making the tunnel during SICS.
  • Instruments which are routinely used for making tunnel are 1 5 number blade/ crescent blade/ keratome knife depending on surgerons choice and experience.
  • the depth of the tunnel is judged by surgical experience. If the depth of the tunnel is too thin, then it causes button hole formation and if the depth of the tunnel is too deep, then it can perforate towards the anterior chamber's angle also called as“premature entry”.
  • An object of the present invention is to provide a tunnel marker device for small incision cataract surgery which causes less astigmatism to a patient.
  • the present invention provides a tunnel marker device ( 100) for small incision cataract surgery.
  • the tunnel marker device (100) comprises an elongated rod shaped handle ( 10) having a first end (1 2) and a second end (14). Specifically, the lower portion of the second end (14) forms the base (14a) for the handle ( 10) .
  • the tunnel marker device ( 100) further comprises a means (20) for making incision having proximal end (22) and distal end (24).
  • the proximal end (22) of the blade (20) is attached to the handle ( 10) at a portion just above the second end ( 14) .
  • the means (20) for incision comprises a flat base (26) and a sharp tip (28) extending downwardly from distal end (22) of the flat base (26).
  • the means for incision (20) is a blade.
  • Figure 1 A to 1 D shows a schematic drawing of types of tunnel made for small incision cataract surgery, in accordance with the prior art
  • FIG. 2 shows a schematic drawing of a tunnel marker device, in accordance with the present invention
  • Figure 3 show a schematic drawing of an embodiment of the tunnel marker device of figure 2;
  • Figure 4 shows a schematic drawing of a blade of the tunnel marker device of figure 2, in accordance with the present invention
  • Figure 5 shows a schematic drawing of the incision made by tunnel marker device of figure 2 and 3.
  • FIG 2-5 there is shown a tunnel marker device (100) for small incision cataract surgery, in accordance with the present invention.
  • the tunnel marker device ( 100) is used to take perfect frown shape and precise depth of about 0.3 to 0.5 mm of the incision for small incision cataract surgery (SICS).
  • the use of tunnel marker device (100) avoids complication like button hole and premature entry. Further, the frown shaped icision made by tunnel marker device (100) gives minimal astigmatism .
  • the tunnel marker device (1 00) is a disposable instrument for sharp incision and to avoid infection.
  • the tunnel marker device (100) comprises a handle ( 10) .
  • the handle (10) is elongated rod shaped member having a first end (12) and a second end (14).
  • the handle (1 0) is made up of any one of plastic and stainless steel.
  • the second end ( 14) of the handle (10) forms the base ( 14a) for the handle ( 10) .
  • the tunnel marker device (100) further comprises a means (20) for making incision attached thereto at a portion just above the second end (14).
  • the means (20) for making incision is a blade as shown in figure 4.
  • the means (20) for making incision is alternatively referred as blade (20) throughout the description).
  • the blade (20) as shown in figure 4 includes proximal end (22) and distal end (24).
  • the proximal end (22) is the attached to the handle ( 10) at a portion just above the second end (14).
  • the blade (20) comprises a flat base (26) and a sharp tip (28) adapted at the distal end (24) extending downwardly from distal end of the flat base (26).
  • the sharp tip (28) is bent downwardly from the flat base (26) forming a 90 degree angulation there between.
  • the length of the tip (28) is prefixed to be 0.3 mm to 0.5 mm .
  • the flat base (26) of the blade (20) is in rectangular or square in shape as shown in figure 2.
  • the flat base (26) is in oval shape as shown in figure 3.
  • the blade (20) is 6.5 mm long and 2 mm wide with sharp pointed tip and is made up of stainless steel. However, it may be evident to those skilled in the art to length and width of the blade (20) as per their requirement.
  • the handle (10) and the blade (20) are configured together in such a fashion that the angulation between blade (20) and handle (1 0) is between 45 degree to 60 degree. Further, the blade (20) is attached to the handle (1 0) in such a way that the base ( 14a) of the second end (14) of the handle ( 10) and the lower end of the tip (28) are in same planar configuration.
  • the handle (10) and the blade (20) are made as a single unit. However, it may be evident to those skilled in the art that to manufacture the handle ( 10) and the blade (20) separately and attach them to each other by means known in the art.
  • the base ( 14a) of the tunnel marker device (100) is placed on the sclera of the eye for support in such a way that the tip (28) of the blade (20) comes at 2 to 3 mm behind the limbus of the eye.
  • the handle (1 0) is rotated in circular fashion so that the blade (20) moves along with the handle (10) thereby forming desired length of incision.
  • the tunnel marker device (100) forms frown shaped incision.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

Disclosed is a tunnel marker device (100) for small incision cataract surgery. The tunnel marker device (100) comprises an elongated rod shaped handle (10) having a first end (12) and a second end (14). Specifically, the lower portion of the second end (14) forms the base (14a) for the handle (10). The tunnel marker device (100) further comprises a means (20) for making incision having proximal end (22) and distal end (24). The proximal end (22) of the blade (20) is attached to the handle (10) at a portion just above the second end (14). Further, the means (20) for incision comprises a flat base (26) and a sharp tip (28) extending downwardly from distal end (22) of the flat base (26).

Description

TUNNEL MARKER DEVICE FOR SMALL INCISION CATARACT SURGERY
Field of invention The present invention relates to a medical device, and more particularly, to a tunnel marker device for use in small incision cataract surgeryto make an incision of a predetermined length and width.
Background of the invention
Medical marking devices have been developed for various surgical operations which involve making incisions in the eye.Modern cataract surgery aims to achieve a better unaided visual acuity with rapid post-surgical recovery and minimal surgery related complications. In small incision cataract surgery (SICS), however, the surgical skill and experience of the surgeon play a significant role. The advantage of manual SICS over other methods of cataract surgery is shorter duration taken making it particularly applicable to high volume cataract surgeries. Specifically, manual SICS can be performed in almost all types of cataracts.
The size of the incision during the cataract surgery decides early visual rehabilitation, better unaided visual acuity and surgical safety. However, the incision size depends on mode of nucleus delivery and type of intraocular lens used. Generally, the size of incision is about 5.5 mm to 7.0 mm in manual small incision cataract surgery.
The SICS, construction of a small, self-sealing sclera- corneal tunnel for delivering the cataractous lens is the main objective, and the procedure of cataracts surgery can be done with either by temporal or superior incision, whichever is more convenient.
The SICS process comprises giving local anesthesia, creating a sclera-corneal tunnel , creating paracentesis, making the internal corneal incision, delivering Capsulorhexis and nucleus to the site, doing residual cortex aspiration and implantation of a posterior chamber intraocular lens and finally, sealing the paracentesis port. Various instruments that are required for construction of the sclera-corneal tunnel are Westcott scissors, cautery, bard-parker knife with #15 blade, Castroviejo calipers, and a crescent blade. Whi le creating tunnel for SICS, size i .e., the length of the tunnel, shape (style) , location, depth, width and entry place into the anterior chamber are important aspects.
While creating a sclera-corneal tunnel, a curvilinear partial-thickness scleral incision is made 3 mm posterior to the limbus. In prior art, several kinds of incisions have been described as follows
1 . Straight tunnel as shown in figure l Awhich causes moderate induced astigmatism
2. Frown tunnel as shown in figure 1 B which is difficult to make with minimal induced astigmatism
3. Smile tunnel as shown in figure I C whichis easy to make, but results in increased astigmatism
4. Chevron tunnel as shown in figure 1 D which is also difficult to make, difficult maneuverability with least/ nil induced astigmatism . Generally, the incision for SICS is smaller for a soft cataract and larger for a dense, and hard cataract. Usually, the incision is 6 to 7 mm long for a cortical cataract and 7 to 8 mm long for a hard cataract (such as 4+ nuclear sclerosis). The depth should be approximately 0.3 mm to 0.5 mm.
Generally, in the prior art, the tunnel for SICS is made by advancing the crescent knife into the sclera and slowly cutting on either side, thereby making room for the crescent knife.
Specifically, adequate depth isjudged by visibility of the knife (i .e., the crescent should be just visible through the sclera). The heel of the crescent knife is required to be flat on the globe during dissection, ensuring uniform depth of the tunnel. More specifically, the sharp tunnel instruments are used to construct the tunnel. For Example, the instrument like Bard-Parker knife with #15 blade , crescent knife and keratome are routiently used for making the tunnel during SICS.
Incision plays the one of the most important role for perfect tunnel making, astigmatism and out come after surgery.
Instruments which are routinely used for making tunnel are 1 5 number blade/ crescent blade/ keratome knife depending on surgerons choice and experience.
However, routinely the depth of the tunnel is judged by surgical experience. If the depth of the tunnel is too thin, then it causes button hole formation and if the depth of the tunnel is too deep, then it can perforate towards the anterior chamber's angle also called as“premature entry”.
Accordingly, there exists a need to provide a medical device for small incision cataract surgery which overcomes abovementi on ed drawbacks. Objects of the invention
An object of the present invention is to provide a tunnel marker device for small incision cataract surgery which causes less astigmatism to a patient.
Another object of the present invention is to provide a tunnel marker device which causes incision for small incision cataract with minimal surgeon skills. Yet another object of the present invention is to provide a tunnel marker device for small incision cataract which is fast, cost effective , less traumatic and reliable.
Summary of the invention Accordingly, the present invention provides a tunnel marker device ( 100) for small incision cataract surgery. The tunnel marker device (100) comprises an elongated rod shaped handle ( 10) having a first end (1 2) and a second end (14). Specifically, the lower portion of the second end (14) forms the base (14a) for the handle ( 10) . The tunnel marker device ( 100) further comprises a means (20) for making incision having proximal end (22) and distal end (24). The proximal end (22) of the blade (20) is attached to the handle ( 10) at a portion just above the second end ( 14) . Further, the means (20) for incision comprises a flat base (26) and a sharp tip (28) extending downwardly from distal end (22) of the flat base (26).
Typically, wherein the means for incision (20) is a blade. Brief description of the drawings
Figure 1 A to 1 D shows a schematic drawing of types of tunnel made for small incision cataract surgery, in accordance with the prior art;
Figure 2 shows a schematic drawing of a tunnel marker device, in accordance with the present invention;
Figure 3 show a schematic drawing of an embodiment of the tunnel marker device of figure 2;
Figure 4 shows a schematic drawing of a blade of the tunnel marker device of figure 2, in accordance with the present invention; and Figure 5 shows a schematic drawing of the incision made by tunnel marker device of figure 2 and 3.
Detailed description of the invention
The foregoing objects of the present invention are accomplished and the problems and shortcomings associated with the prior art, techniques and approaches are overcome by the present invention as described below in the preferred embodiment.
Referring now to figure 2-5, there is shown a tunnel marker device (100) for small incision cataract surgery, in accordance with the present invention. The tunnel marker device ( 100) is used to take perfect frown shape and precise depth of about 0.3 to 0.5 mm of the incision for small incision cataract surgery (SICS). The use of tunnel marker device (100) avoids complication like button hole and premature entry. Further, the frown shaped icision made by tunnel marker device (100) gives minimal astigmatism . The tunnel marker device (1 00) is a disposable instrument for sharp incision and to avoid infection.
The tunnel marker device (100) comprises a handle ( 10) . The handle (10) is elongated rod shaped member having a first end (12) and a second end (14). In an embodiment, the handle (1 0) is made up of any one of plastic and stainless steel. The second end ( 14) of the handle (10) forms the base ( 14a) for the handle ( 10) .
The tunnel marker device (100) further comprises a means (20) for making incision attached thereto at a portion just above the second end (14). In an embodiment, the means (20) for making incision is a blade as shown in figure 4. (The means (20) for making incision is alternatively referred as blade (20) throughout the description). The blade (20) as shown in figure 4 includes proximal end (22) and distal end (24). The proximal end (22) is the attached to the handle ( 10) at a portion just above the second end (14). Further, the blade (20) comprises a flat base (26) and a sharp tip (28) adapted at the distal end (24) extending downwardly from distal end of the flat base (26). Further, the sharp tip (28) is bent downwardly from the flat base (26) forming a 90 degree angulation there between. In preferred embodiment, the length of the tip (28) is prefixed to be 0.3 mm to 0.5 mm . However, it may be evident to those skilled in the art to alter the length of tip (28) as per their requirement.
In preferred embodiment, the flat base (26) of the blade (20) is in rectangular or square in shape as shown in figure 2. In an embodiment, the flat base (26) is in oval shape as shown in figure 3. In an embodiment, the blade (20) is 6.5 mm long and 2 mm wide with sharp pointed tip and is made up of stainless steel. However, it may be evident to those skilled in the art to length and width of the blade (20) as per their requirement.
The handle (10) and the blade (20) are configured together in such a fashion that the angulation between blade (20) and handle (1 0) is between 45 degree to 60 degree. Further, the blade (20) is attached to the handle (1 0) in such a way that the base ( 14a) of the second end (14) of the handle ( 10) and the lower end of the tip (28) are in same planar configuration.
In an embodiment, the handle (10) and the blade (20) are made as a single unit. However, it may be evident to those skilled in the art that to manufacture the handle ( 10) and the blade (20) separately and attach them to each other by means known in the art.
As shown in figure 5, during small incision cataract surgery, the base ( 14a) of the tunnel marker device (100) is placed on the sclera of the eye for support in such a way that the tip (28) of the blade (20) comes at 2 to 3 mm behind the limbus of the eye. The handle (1 0) is rotated in circular fashion so that the blade (20) moves along with the handle (10) thereby forming desired length of incision. In an embodiment, the tunnel marker device (100) forms frown shaped incision.
The foregoing descriptions of specific embodiments of the present invention have been presented for purposes of illustration and description. They are not intended to be exhaustive or to limit the present invention to the precise forms disclosed, and obviously many modifications and variations are possible in light of the above teaching. The embodiments were chosen and described in order to best explain the principles of the present invention and its practical application, and to thereby enable others skilled in the art to best utilize the present invention and various embodiments with various modifications as are suited to the particular use contemplated. It is understood that various omissions and substitutions of equivalents are contemplated as circumstances may suggest or render expedient, but such omissions and substitutions are intended to cover the application or implementation without departing from scope of the invention.

Claims

I Claim
1 . A tunnel marker device ( 100) for small incision cataract surgery comprising:
an elongated rod shaped handle (10) having a first end ( 12) and a second end (14), the lower portion of the second end (14) forms the base ( 14a) for the handle ( 10) ; and
a means (20) for making incision having proximal end (22) and distal end (24) , the proximal end (22) being attached to the handle (1 0) at a portion just above the second end ( 14) , the means (20)for incision having flat base (26) and a sharp tip (28) extending downwardly from distal end(22) of the flat base (26).
1 . The tunnel marker device (100) as claimed i n claim 1 , wherein the means for incision (20) is a blade.
2. The tunnel marker device (100) as claimed i n claim 1 , wherein the sharp tip (28) is bent downwardly from the flat base (26) forming a 90 degree angulation therebetween.
3. The tunnel marker device (100) as claimed in claim 1 , wherein the flat base (22) of the means (20) for making incision is made in any one of rectangular, square and oval shape.
4. The tunnel marker device ( 100) as claimed in claim 1 , wherein the handle ( 10) and the means for making incision (20) are configured together in an angulation between 45 degree to 60 degree.
5. The tunnel marker device (100) as claimed in claim 1 , wherein base of the second end ( 14) of the handle ( 10) and the lower end of the tip (28) are in same planar configuration.
PCT/IN2020/050101 2019-02-07 2020-01-31 Tunnel marker device for small incision cataract surgery WO2020161734A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN201921004917 2019-02-07
IN201921004917 2019-02-07

Publications (1)

Publication Number Publication Date
WO2020161734A1 true WO2020161734A1 (en) 2020-08-13

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PCT/IN2020/050101 WO2020161734A1 (en) 2019-02-07 2020-01-31 Tunnel marker device for small incision cataract surgery

Country Status (1)

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Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007087061A2 (en) * 2006-01-17 2007-08-02 Transcend Medical, Inc. Glaucoma treatment device

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007087061A2 (en) * 2006-01-17 2007-08-02 Transcend Medical, Inc. Glaucoma treatment device

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